This study is designed to test the potential application of a problem-solving education intervention for patients and family caregivers experiencing allogeneic hematopoietic stem cell transplantation (HSCT). An increase in problem-solving has been shown to decrease distress and may improve symptom distress and health related QOL. The Prepared Family Caregiving intervention, also known as COPE, has demonstrated benefit in cancer patients and their families, however there are limitations to its current application. Only one study has reported the application of this intervention in the acute care setting and no study has been done with patients undergoing HSCT. Subjects were accrued to this protocol once they have agreed to participate in an allogeneic HSCT at the Clinical Center, NIH. The study completed enrollment 1/2008. Of the thirty-four adult dyads screened, twenty-four were ineligible primarily due to non-English speaking (n=11) and inconsistent caregivers (n=10). Ten dyads (n=20) were enrolled and eight dyads (n=16) completed the intervention. Of the thirty-one sessions, 29 were completed (94%). Worsening patient condition was the primary reason for sessions to be incomplete. Patients attended 90% of the sessions; caregivers attended 74%. Reasons for missed sessions included patient symptom distress and limited caregiver availability. Dyads reported being very satisfied (4.8+0.61; range 1-5) stating an opportunity to talk and creative thinking were most beneficial. Results suggest that dyads can participate in PSE during HSCT and view it as beneficial. Participants identified the active process of solving problems as helpful. Targeted interventions that promote effective, meaningful behaviors are needed to guide patients and caregivers through HSCT. Future research recommendations